Dr. Woodburn discusses discontinuation of Botox treatment for OAB

In this video, Katherine L. Woodburn, MD, shares notable findings, potential directions, and key takeaways from the recent study, “OnabotulinumtoxinA discontinuation in patients with prior nerve stimulation." Woodburn is an assistant professor of urogynecology at Atrium Health Wake Forest Baptist in High Point and Winston-Salem, North Carolina.

Video Transcript:

First Slide

We noted in our overall population, which was about 214 women, there was a 40% discontinuation rate for Botox treatments in the office. This wasn't that surprising. It matches up with a lot of what the other literature suggest. We did find that patients who had recurrent treatment associated urinary tract infections (UTIs) had a higher chance of stopping Botox treatment.

What really surprised us was that 25% of our Botox cohort had previously undergone nerve stimulation, whether that's sacral neuromodulation or peripheral tibial nerve stimulation, and those patients were less likely to stop Botox.

Second Slide

I don't currently have any research going on in this area, but we are looking about how Botox works in a more elderly patient population as well as if factors play into their discontinuation rates of Botox.

I think based on the findings of our study, it would be interesting to look at why patients are stopping Botox. A lot of the patients in our study and other studies previously published are lost to follow-up, and we need more information. Did they stop because it wasn't working? Did they stop for other reasons? I think a great next step would be some patient-centered research, maybe in a qualitative fashion.

Third Slide

I think unfortunately, our study corroborates that there are high Botox discontinuation rates for patients overall. That's probably the biggest take-home, as well as the fact that patients who have recurrent treatment associated infections are more likely to stop. So maybe being a little bit more aggressive in how we treat or prevent those treatment associated UTIs could be helpful for those patients. Overall, we need more information about why women choose to stop Botox treatment and if there are things that we could be helping in that regard.